scholarly journals Early Results of ERAS (Enhanced Recovery After Surgery) Protocol in Orthopaedic Surgery

The Physician ◽  
2012 ◽  
Vol 1 (1) ◽  
pp. 28-32
Author(s):  
Jaydeep Shah ◽  
Keshav Singhal
Keyword(s):  
Colorectal Surgery ◽  
Knee Replacement ◽  
Orthopaedic Surgery ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Hospital Inpatient ◽  
Inpatient Stay ◽  
Average Hospital ◽  
Replacement Surgery ◽  
Eras Protocol

Background: The concept of a fast track (Enhanced Recovery After Surgery, ERAS) was introduced to colorectal surgery in Denmark by Kehlet in 1999 which improved the quality of the care and reduced the length of hospital stay following major colorectal surgery. The same principles of ERAS have been applied to the orthopaedic surgery particularly the hip and knee replacement surgery and fracture neck of femur surgery. It is a relatively new approach in orthopaedics to the preoperative, intraoperative and postoperative care of the patients undergoing surgery.   Methods: We have compared the length of inpatient stay, day of mobilisation, postoperative blood transfusion and adverse outcome for the patients undergoing hip or knee replacement by a single surgeon (KS) between ERAS and NON ERAS patients.   Results: A total of 138 patients underwent hip or knee replacement, hip resurfacing arthroplasty or oxford unicompartmental arthroplasty between July 2011 and June 2012 with ERAS protocol. In the Non-ERAS group, 140 patients underwent hip or knee arthroplasty, resurfacing or oxford uni-compartmental knee replacement in the previous year (July 2010 to June 2011) by the same surgeon. Average hospital inpatient stays for the ERAS patients was 4.12 days with 73.10% of the patients having an inpatient hospital stay of less than or equal to 5 days. The average hospital inpatient stays for the NON-ERAS patients was 8.34 days with only 24.08% of the patients being discharged in less than or equal to 5 days.   Conclusions: Our study shows that the implementation of the ERAS protocol in hip and knee replacement surgery is associated with improved patient experience, faster recovery and shorter hospital inpatient stay with no increase in complication.

scholarly journals Implementation of an ERAS Pathway in Colorectal Surgery

2019 ◽  
Vol 32 (02) ◽  
pp. 102-108 ◽  
Author(s):  
Liliana Bordeianou ◽  
Paul Cavallaro
Keyword(s):  
Colorectal Surgery ◽  
Length Of Stay ◽  
Postoperative Care ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Standardized Protocol ◽  
Improve Hospital ◽  
Eras Protocol

AbstractEnhanced Recovery after Surgery (ERAS) protocols have been demonstrated to improve hospital length of stay and outcomes in patients undergoing colorectal surgery. This article presents the specific components of an ERAS protocol implemented at the authors' institution. In particular, details of both surgical and anesthetic ERAS pathways are provided with explanation of all aspects of preoperative, perioperative, and postoperative care. Evidence supporting inclusion of various aspects within the ERAS protocol is briefly reviewed. The ERAS protocol described has significantly benefitted postoperative outcomes in colorectal patients and can be employed at other institutions wishing to develop an ERAS pathway for colorectal patients. A checklist is provided for clinicians to easily reference and facilitate implementation of a standardized protocol.

Enhanced Recovery After Surgery (ERAS) Protocol: Prospective Study of Outcome in Colorectal Surgery

2012 ◽  
Vol 112 (5) ◽  
pp. 355-358 ◽  
Author(s):  
J. Fierens ◽  
A.M. Wolthuis ◽  
F. Penninckx ◽  
A.D. D’Hoore ◽  
A. D’Hoore
Keyword(s):  
Colorectal Surgery ◽  
Prospective Study ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Eras Protocol

scholarly journals Does Implementation of Enhanced Recovery after Surgery (ERAS) Protocols in Colorectal Surgery Improve Patient Outcomes?

2019 ◽  
Vol 32 (02) ◽  
pp. 109-113 ◽  
Author(s):  
Julia Berian ◽  
Clifford Ko ◽  
Kristen Ban
Keyword(s):  
Colorectal Surgery ◽  
Patient Outcomes ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Process Measures ◽  
Improved Outcomes ◽  
Preoperative Carbohydrate Loading ◽  
Eras Protocol ◽  
Implementation Data ◽  
Improve Patient

AbstractEnhanced Recovery after Surgery (ERAS) protocols are multimodal perioperative care pathways designed to accelerate recovery by minimizing the physiologic stress of a surgical procedure. Benefits of ERAS implementation in colorectal surgery include reduced length of stay and decreased complications without an increase in readmissions. Though there is evidence associating individual ERAS protocol elements (e.g., preoperative carbohydrate loading, judicious perioperative fluid administration, and early initiation of postoperative nutrition) with improved outcomes, ensuring high compliance with all elements of an ERAS protocol will maximize benefits to the patient. After ERAS implementation, data collection on protocol process measures can help providers target education and interventions to improve protocol compliance and patient outcomes.

Acute kidney injury following implementation of an enhanced recovery after surgery (ERAS) protocol in colorectal surgery

2018 ◽  
Vol 33 (9) ◽  
pp. 1259-1267 ◽  
Author(s):  
Joseph H. Marcotte ◽  
Kinjal Patel ◽  
Ronak Desai ◽  
John P. Gaughan ◽  
Deviney Rattigan ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Colorectal Surgery ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Kidney Injury ◽  
Eras Protocol

Outcomes in colorectal surgery at reina sofia clinic, Bogota, Colombia, after the implementation of the enhanced recovery after surgery (ERAS) protocol

2018 ◽  
Vol 25 ◽  
pp. 172
Author(s):  
Eduardo Zarate ◽  
Angela Navas ◽  
Arnold Barrios ◽  
Alvaro Sarmiento ◽  
Jairo Betancourt ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Eras Protocol

scholarly journals Reducing hospital stay for colorectal surgery in ERAS setting by means of perioperative patient education of expected day of discharge

2021 ◽  
Author(s):  
Thaís T. T. Tweed ◽  
Carmen Woortman ◽  
Stan Tummers ◽  
Maikel J. A. M. Bakens ◽  
James van Bastelaar ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colorectal Surgery ◽  
Standard Care ◽  
Primary Outcome ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Single Centre ◽  
Expectation Management ◽  
Secondary Outcomes ◽  
Eras Protocol

Abstract Purpose Despite the enhanced recovery after surgery (ERAS) protocol, length of stay (LOS) after colorectal surgery varies considerably. The majority of longer admissions is often not medically necessary. We aimed to investigate possible reduction of LOS by perioperative education with an expected discharge date (EDD). Methods This single-centre retrospective study included 578 patients who underwent surgery for colorectal cancer in 2016 with standard care (ERAS) and in 2018 with the addition of EDD education program (ERAS+). A comparison was made of a 1-year period prior to and following the implementation of EDD. The EDD was discussed at the outpatient clinic, preoperatively and during admission (with both the patient and family members daily). Standard EDD varied between 3 and 5 days depending on the resection type. Primary outcome was LOS; secondary outcomes were readmission, serious complications and 90-day mortality. Results Patients in ERAS+ (n = 242) had a shorter median LOS (4.0 vs. 5.0, p < 0.001) compared to patients in the regular ERAS group (n = 336). Fewer patients of ERAS+ experienced postoperative complications (71 (29.3%) vs. 198 (58.9%), p < 0.001). No difference was found in the number of readmissions (23 (9.5%) vs. 34 (10.1%), p = 0.807), reinterventions (25 (10.3%) vs. 30 (8.9%), p = 0.571) or mortality (5 (2.1%) vs. 9 (2.7%), p = 0.261) between the two groups. Conclusion It is possible to reduce LOS within the ERAS program, by better perioperative education and expectation management of patients with use of an EDD. This program ensures better understanding, faster discharge and lower costs for the hospital without added risk of readmissions or complications.

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